Svetozarskiy S N, Kopishinskaya S V, Ruina E A, Antipenko E A
Volga Regional Medical Center of the Federal Medical-Biological Agency, Nizhny Novgorod, Russia.
Privolzhsky Research Medical University, Nizhny Novgorod, Russia.
Vestn Oftalmol. 2023;139(2):61-67. doi: 10.17116/oftalma202313902161.
Neuromyelitis optica spectrum disorders (NMOSD) comprise a group of autoimmune inflammatory demyelinating diseases of the central nervous system that manifest as optic neuritis and transverse myelitis. Its manifestation in the form of optic neuritis makes early diagnosis difficult because neuroimaging of the spinal cord is not a part of the routine examination algorithm for such patients. This article presents the results of a comprehensive ophthalmological examination of 4 patients (8 eyes) diagnosed with NMSOD. Optic neuritis was the disease debut in 3 patients and had 1-2 relapses, in all cases partial optic atrophy with moderate to severe loss of visual function occurred. The clinical picture was characterized by a pronounced heterogeneity in terms of both ophthalmological symptoms, and accession of neurological disorders. Treatment of NMOSD requires differential diagnosis with multiple sclerosis, which depends on the awareness of specialists and the inclusion of antibody titers to aquaporin-4 and myelin oligodendrocyte glycoprotein into the examination algorithm of patients with optical neuritis.
视神经脊髓炎谱系障碍(NMOSD)是一组中枢神经系统的自身免疫性炎性脱髓鞘疾病,表现为视神经炎和横贯性脊髓炎。其以视神经炎形式出现使得早期诊断困难,因为脊髓神经成像并非此类患者常规检查流程的一部分。本文介绍了4例(8只眼)被诊断为NMOSD患者的全面眼科检查结果。视神经炎是3例患者的首发疾病,有1 - 2次复发,所有病例均出现部分视神经萎缩及中度至重度视功能丧失。临床表现的特点是眼科症状和神经系统疾病的出现都存在明显的异质性。NMOSD的治疗需要与多发性硬化症进行鉴别诊断,这取决于专科医生的认知以及将水通道蛋白4和髓鞘少突胶质细胞糖蛋白的抗体滴度纳入视神经炎患者的检查流程。